Mauricio Lask Knizek, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25955 Issued in CA

Practice address

2397 Shattuck Ave Ste 206
Berkeley, CA 94704-1567

Phone

(510) 863-1134

NPI assigned

Feb 25, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Concord, CA
  • NPI 1538181482
  Medicare reassignment Care Compare group
• Lifelong Medical Care

  • Geriatric Medicine (Family Medicine) Physician
  • Berkeley, CA
  • NPI 1689670002
  Medicare reassignment NPD
• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1144336181
  NPD
• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1346262292
  NPD
• La Clinica de la Raza, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1427070374
  NPD
• Lifelong Medical Care

  • Family Medicine Physician
  • Rodeo, CA
  • NPI 1003289463
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1558501973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2397 SHATTUCK AVE STE 206",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041567",
            "telephone_number": "510-863-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2397 SHATTUCK AVE STE 206",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041567",
            "telephone_number": "510-863-1134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Fruitvale Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946012313",
            "country_code": "US",
            "telephone_number": "510-238-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASK KNIZEK",
        "first_name": "MAURICIO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-25",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Laroia, DNP-FNP
• Fiona Elke Larsen-Teskey
• Karin Elizabeth Larson, RADT 1
• Michael Larson, LMFT
• Beverly Lashley
• Pujita Jessica Latchman
• Paola Latorre-Rey, B.S.
• Andrew Yau-Tung Lau, DR.OF PHARMACY
• Jan Lau
• Teresa W Lau, D.C.

• Clinical Psychologist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.